Category Archives: Heart Disease

Natural Ways to Treat Hypertension

You may need to cut back on alcohol Photo copyright: Steve Parker MD

You may need to cut back on alcohol.
Photo copyright: Steve Parker

Drugs to control hypertension can save your life. I prescribe them all the time. However, there are also “natural” ways to control high blood pressure. Click the link at bottom for some of the better known methods from Kerri-Ann Jennings, RD. If you’re trying to avoid drugs, you’ll probably need a combination of tricks. And they don’t work for everybody.

Even if you’re already on drugs, you may be able to cut back or stop them if you adopt some of these tips.

“High blood pressure is a dangerous condition that can damage your heart. It affects one in three people in the US and 1 billion people worldwide.

If left uncontrolled, it raises your risk of heart disease and stroke.

But there’s good news. There are a number of things you can do to lower your blood pressure naturally, even without medication.Here are 15 natural ways to combat high blood pressure.”

Source: 15 Natural Ways to Lower Your Blood Pressure

h/t Jan at The Low Carb Diabetic

Paleo Diet Reduced Low-Grade Inflammation In Obese Postmenopausal Women

I haven’t read the entire article, so probably can’t answer any of your questions. When you read “android fat” below, think “belly fat,” which is linked to poor health outcomes compared to non-belly fat.

OBJECTIVE: Abdominal fat accumulation after menopause is associated with low-grade inflammation and increased risk of metabolic disorders. Effective long-term lifestyle treatment is therefore needed.

METHODS: Seventy healthy postmenopausal women (age 60 ± 5.6 years) with BMI 32.5 ± 5.5 were randomized to a Paleolithic-type diet (PD) or a prudent control diet (CD) for 24 months. Blood samples and fat biopsies were collected at baseline, 6 months, and 24 months to analyze inflammation-related parameters.

RESULTS: Android fat decreased significantly more in the PD group (P = 0.009) during the first 6 months with weight maintenance at 24 months in both groups. Long-term significant effects (P < 0.001) on adipose gene expression were found for toll-like receptor 4 (decreased at 24 months) and macrophage migration inhibitory factor (increased at 24 months) in both groups. Serum interleukin 6 (IL-6) and tumor necrosis factor α levels were decreased at 24 months in both groups (P < 0.001) with a significant diet-by-time interaction for serum IL-6 (P = 0.022). High-sensitivity C-reactive protein was decreased in the PD group at 24 months (P = 0.001).

CONCLUSIONS: A reduction of abdominal obesity in postmenopausal women is linked to specific changes in inflammation-related adipose gene expression.

Source: Attenuated Low-Grade Inflammation Following Long-Term Dietary Intervention in Postmenopausal Women with Obesity. – PubMed – NCBI

FDA Says Jardiance Can Be Marketed as Cardiovascular Death-Defying

Jardiance is a diabetes drug in the class called SGLT2 inhibitors.

How do they work? Our kidneys filter glucose (sugar) out of our bloodstream, then reabsorb that glucose back into the bloodstream. SGLT2 inhibitors impair that reabsorption process, allowing some glucose to be excreted in our urine. You could call it a diuretic effect. For example, an SGLT 2 inhibitor called dapagliflozin, at a dose of 10 mg/day, causes the urinary loss of 70 grams of glucose daily.

How drugs like this could prevent cardiovascular disease in type 2 diabetics is a mystery to me.

From MPT:

“The diabetes drug empagliflozin (Jardiance) may be marketed for prevention of cardiovascular death in patients with type 2 diabetes and co-existing cardiovascular disease, the FDA said Friday.

It’s the first such claim ever allowed for a diabetes drug.

Empagliflozin, first approved in 2014, is an inhibitor of the sodium-glucose co-transporter 2 (SGLT2) pathway, reducing blood glucose by causing it to be excreted in urine.Its benefit for cardiovascular risk reduction was demonstrated in the so-called EMPA-REG trial, results of which were reported in 2015.”

Source: Jardiance Wins CV Prevention Indication | Medpage Today

Fish Fraud: 1 in 5 Seafoods Are Labeled Wrong

Wish I were here

Wish I were here

Fraudulent labeling of fish and other seafood is a problem. It matters to me because I advocate frequent consumption of cold-water fatty fish as healthful. It’s the omega-3 fatty acids in those fish that are particularly good for you.

If what you believe to be trout is actually catfish, you’re not getting the omega-3s you paid for.

Click over to the New York Times for details:

“One in five seafood samples tested worldwide turns out to be completely different from what the menu or packaging says, according to a report on seafood fraud released Wednesday by the ocean conservation group Oceana. Of the more than 25,000 seafood samples the group analyzed, 20 percent were incorrectly labeled.“It is likely that the average consumer has eaten mislabeled fish for sure,” said Beth Lowell, the senior campaign director for Oceana and an author of the paper. “You’re getting ripped off, while you enjoyed your meal you’re paying a high price for a low fish.”

Source: Catfished by a Catfish: 1 in 5 Seafood Samples Is Fake, Report Finds – The New York Times

Raw oysters qualify as paleo

Raw oysters qualify as paleo

On a related note…I’ve been eating a lot of canned smoked oysters lately. Nearly all on the supermarket shelves in Arizona USA come from China. Why is that? I worry about pollutants in those oysters, regardless of provenance. If you have any info on this issue, please share.

Steve Parker, M.D.

PS: Search my blog for the list of high omega-3 cold-water fatty fish, or read my books.

It’s the Carbs, Not Saturated Fat: Food consumption and the rate of cardiovascular diseases in 42 European countries 

 

Carcinogenic?

Carcinogenic?

The idea that heart attacks and other cardiovascular diseases are caused by dietary saturated fats is losing credibility. I lost faith in that theory in 2009.

Instead, cardiovascular disease is now linked to high consumption of carbohydrates, particularly those carbs that are rapidly absorbed and turned into blood sugar.

Unfortunately, the diet that reduces risk of cardiovascular disease may increase your risk of cancer. Keep reading.

If you’re a nutrition science nerd, here’s a pertinent report from researchers at Masaryk University in the Czech Republic:

“The results of our study show that high-glycaemic carbohydrates or a high overall proportion of carbohydrates in the diet are the key ecological correlates of cardiovascular disease (CVD) risk. These findings strikingly contradict the traditional ‘saturated fat hypothesis’, but in reality, they are compatible with the evidence accumulated from observational studies that points to both high glycaemic index and high glycaemic load (the amount of consumed carbohydrates × their glycaemic index) as important triggers of CVDs. The highest glycaemic indices (GI) out of all basic food sources can be found in potatoes and cereal products, which also have one of the highest food insulin indices (FII) that betray their ability to increase insulin levels.The role of the high glycaemic index/load can be explained by the hypothesis linking CVD risk to inflammation resulting from the excessive spikes of blood glucose (‘post-prandial hyperglycaemia’). Furthermore, multiple clinical trials have demonstrated that when compared with low-carbohydrate diets, a low-fat diet increases plasma triglyceride levels and decreases total cholesterol and HDL-cholesterol, which generally indicates a higher CVD risk. Simultaneously, LDL-cholesterol decreases as well and the number of dense, small LDL particles increases at the expense of less dense, large LDL particles, which also indicates increased CVD risk. These findings are mirrored even in the present study because cereals and carbohydrates in general emerge as the strongest correlates of low cholesterol levels.

In light of these findings, the negative correlation of refined sugar with CVD risk may seem surprising, but the mean daily consumption of refined sugar in Europe is quite low (~84 g/day), when compared with potato and cereal carbohydrates (~235 g/day), and makes up only ~20% of CA energy. Refined sugar is also positively tied to many animal products such as animal fat and total fat and animal protein, and negatively to % PC CARB energy and % CA energy. Therefore, a high consumption of refined sugar is accompanied by a high consumption of animal products and lower intakes of other carbohydrates. Furthermore, the glycaemic index of refined sugar (sucrose) is rather moderate (~65).”

Source: Food consumption and the actual statistics of cardiovascular diseases: an epidemiological comparison of 42 European countries | Grasgruber | Food & Nutrition Research

Elsewhere in this long article:

“Current rates of cancer incidence in Europe are namely the exact geographical opposite of CVDs. In sharp contrast to CVDs, cancer correlates with the consumption of animal food (particularly animal fat), alcohol, a high dietary protein quality, high cholesterol levels, high health expenditure, and above average height. These contrasting patterns mirror physiological mechanisms underlying physical growth and the development of cancer and CVDs. The best example of this health paradox is again that of French men, who have the lowest rates of CVD mortality in Europe, but the highest rates of cancer incidence. In other words, cancer and CVDs appear to express two extremes of a fundamental metabolic disbalance that is related to factors such as cholesterol and IGF-1 (insulin-like growth factor).”

I wish these researchers had looked at over death rates associated with various ways of eating. Perhaps that will be in a future paper.

I’d rather die of a heart attack than cancer.

Steve Parker, M.D.

Grain-free paleolithic diet improves cholesterol levels better than traditional “heart healthy diet”

See modern man walking off that cliff?

See modern man walking off that cliff?

I haven’t read the full text of this new study, but here’s the abstract in case you’re interested:

“Recent research suggests that traditional grain-based heart-healthy diet recommendations, which replace dietary saturated fat with carbohydrate and reduce total fat intake, may result in unfavorable plasma lipid ratios, with reduced high-density lipoprotein (HDL) and an elevation of low-density lipoprotein (LDL) and triacylglycerols (TG). The current study tested the hypothesis that a grain-free Paleolithic diet would induce weight loss and improve plasma total cholesterol, HDL, LDL, and TG concentrations in nondiabetic adults with hyperlipidemia to a greater extent than a grain-based heart-healthy diet, based on the recommendations of the American Heart Association.

Twenty volunteers (10 male and 10 female) aged 40 to 62 years were selected based on diagnosis of hypercholesterolemia. Volunteers were not taking any cholesterol-lowering medications and adhered to a traditional heart-healthy diet for 4 months, followed by a Paleolithic diet for 4 months. Regression analysis was used to determine whether change in body weight contributed to observed changes in plasma lipid concentrations. Differences in dietary intakes and plasma lipid measures were assessed using repeated-measures analysis of variance.

Four months of Paleolithic nutrition significantly lowered (P < .001) mean total cholesterol, LDL, and TG and increased (P < .001) HDL, independent of changes in body weight, relative to both baseline and the traditional heart-healthy diet. Paleolithic nutrition offers promising potential for nutritional management of hyperlipidemia in adults whose lipid profiles have not improved after following more traditional heart-healthy dietary recommendations.”

 

Source: Paleolithic nutrition improves plasma lipid concentrations of hypercholesterolemic adults to a greater extent than traditional heart-healthy dietar… – PubMed – NCBI

Increase in consumption of refined carbohydrates and sugar may have led to the health decline of the Greenland Eskimos 

Not much edible carbohydrate this time of year...

Not much edible carbohydrate this time of year…

From Dr. James Dr. DiNicolantonio:

“In conclusion, an increase in the intake of refined carbohydrate and sugar paralleled the rise in atherosclerotic disease in the Greenland Eskimos. While the total carbohydrate intake of the Greenland Eskimos was just 2–8% of total calories in 1855, this increased to around 40% of calories by 1955.5 The Greenland Eskimos studied by Bang and Dyerberg in the 1970s no longer consumed a traditional healthy Eskimo diet. Indeed, the intake of refined sugar in the Greenland Eskimos increased by almost 30-fold from 1855 (6 g/person/day or around 1½ teaspoonful of sugar) to the 1970s (164–175 g or around 40–44 teaspoonful of sugar). Moreover, the intake of refined carbohydrate increased 5–7-fold from 1855 (18 g/day from bread) to the 1970s (84–134 g/day from bread, biscuits and rye flour).

In summary, the intake of refined carbohydrate and sugar by the Greenland Eskimos increased in parallel to the rise in atherosclerotic disease. Considering that a similar event occurred in the USA and that the overconsumption of refined sugar is a principal driver of type 2 diabetes, hypertension, and coronary heart disease, this most likely explains the health decline of the Greenland Eskimos.”

Source: Increase in the intake of refined carbohydrates and sugar may have led to the health decline of the Greenland Eskimos — DiNicolantonio 3 (2) — Open Heart

Does Diabetes Drug Empagliflozin Reduce Heart Disease Risk?

diabetic mediterranean diet, Steve Parker MD

Pharmacist using her advanced degree to count pills

Larry Husten writing at CardioBrief mentions a recent press release alleging that empagliflozin reduces cardiovascular disease risk.

Larry points out a problem with diabetes drugs that I’ve been harping on for years: we don’t know the long-term outcomes and side effects of most of our drugs. As long as a diabetes drug reduces blood sugar and seems to be relatively safe in the short term, it will be approved for use by the U.S. Food and Drug Administration. Larry writes:

Until now the best thing anyone could say for sure about all the new diabetes drugs was that at least they didn’t kill people. That’s because although these drugs have been shown to be highly effective in reducing glucose levels, a series of large cardiovascular outcomes trials failed to provide any evidence of significant clinical benefit.

Cardiovascular disease is a major stalker of diabetics. I’m talking about heart attacks, strokes, heart failure, sudden cardiac death.

The aforementioned press release touts reduced cardiovascular disease risk in patients taking empagliflozin. What’s missing is any mention of overall death reduction. Even if the drug really prevents heart attacks and strokes, which I doubt, don’t you want to know about overall death rates? I do. For all we know, the drug could promote illness and death from infections and cancer while reducing heart attacks and strokes. The drug’s net effect could be premature death. 

I’m 99% certain the researchers doing the work have the mortality data. Unless they don’t want to know.

By no means am I against drug use. But if I had type 2 diabetes, I’d do all I can with exercise, weight control, and low-carb eating before resorting to new or higher doses of drugs.

Steve Parker, M.D.

Dietary Saturated Fat Doesn’t Influence Future Course of Coronary Heart Disease

kkk

Most heart attacks occur in folks with pre-existing coronary artery disease that’s been present for years

If you already have coronary artery disease, Dr. Axel Sigurdsson says that ongoing saturated fat intake probably doesn’t matter, in terms of future cardiac events (like heart attacks) or risk of death from any cause.

Dr. Sigurdsson is a cardiologist in Iceland.

Some quotes from his blog:

For decades, cardiologists have advised patients with heart disease to restrict the intake of saturated fats and dietary cholesterol. Many patients still believe this to be the cornerstone of their lifestyle modification.

The main reason for avoiding saturated fats is the assumption that they adversely affect the lipid profile of our patients.

*   *   *

Recent studies suggest that the recommendation to avoid saturated fats may have been premature and not based on solid scientific evidence.

Now, a recently published Norwegian study shows that dietary intake of saturated fatty acids was not associated with risk of future events or death among patients with established coronary artery disease.

It is important to keep in mind that most of the patients were receiving secondary prevention drug therapy including aspirin, beta blockers and statins.

Anyhow, the results of the study certainly suggest that high intake of saturated fats is not a risk factor among patients with coronary heart disease receiving modern-day treatment.

These recent scientific data don’t imply hat we should urge our patients to consume high amounts of saturated fats. They only tell us that there is no association and accordingly, restriction won’t help.

So, it’s certainly a lifeline for those who believe red meat, whole-fat milk, cheese, cream, butter and eggs can be a part of a healthy diet.

On the other hand we must realise that scientific studies often provide contradictory results. A US study published last year suggested that greater adherence to a low carbohydrate diet high in animal sources of fat and protein was associated with higher all-cause and cardiovascular mortality following acute heart attack.

It appears the jury is still out…

RTWT.

Steve Parker, M.D.

Low-Carb Diet Beats Low-Fat for Weight Loss While Improving Cardiovascular Risk Factors

…according to an article at MedPageToday.

Many physicians have been reluctant to recommend low-carb diets out of fear that they increase cardiovascular risk. How could that happen? By replacing carbohydrates with fats, especially saturated fats, leading to atherosclerosis. I don’t buy that theory (here’s why).

medical clearance, treadmill stress test

This treadmill stress test is looking for atherosclerotic heart disease, aka coronary artery disease and coronary heart disease

A recent study compared low-carb to low-fat dieting over 12 months and actually found better improvements in cardiovascular disease risk factors on the low-carb diet (max of 40 grams a day).

After 12 months, folks on a low-carbohydrate diet had lost 5.3 kg (11.7 lb), while those on a low-fat diet with similar caloric value had lost 1.8 kg (3.9 lb). Both groups showed lowering of LDL cholesterol, while the low-carbers had better improvements in HDL cholesterol and triglycerides.

DietDoctor Andreas Eenfeldt can add this study to his list of others that show better weight loss with low-carb diets compared to low-fat.

Steve Parker, M.D.